To the Editor: Dr Weeks and colleagues1 conclude that the modest short-term QOL benefits
of LAC are insufficient to justify its use in the treatment of colon cancer.
However, we are less certain of this conclusion because there may have been
varying degrees of laparoscopic expertise across the different centers. The
recruitment of 289 patients from 37 centers in 42 months suggests an average
of 2 patients per year enrolled at each center. The authors should provide
data about the distribution of patients recruited and the average volume of
procedures routinely performed to understand whether hospitals with low volumes
of these surgeries were included in the trial. We believe that 20 laparoscopic
colonic surgical cases are not a sufficient experience to be eligible and
credentialed for participating in randomized trials about LAC for cancer.